NPIMap

Organization Active NPI

Pediatric Home Healthcare, LLC

  • Home Health Agency
  • Fort Worth, TX
National Provider Identifier
1003108721
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PEDIATRIC HOME HEALTHCARE, LLC
Practice address
1300 Summit Ave
Suite 430
Fort Worth, TX 76102
Phone
(817) 710-7442
NPI assigned
May 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dennis Allen Hosley Jr.
Title
Coo
Phone
(972) 630-4811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1300 Summit Ave
Suite 430
Fort Worth, TX 76102

Mailing address

17950 Preston Rd Ste 370
Dallas, TX 75252-6205
Phone (972) 630-4811

Other identifiers 1

IdentifierTypeStateIssuer
014301MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Home Healthcare9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1300 Summit Ave
Ste 430
Fort Worth, TX 76102
Phone (817) 710-7442

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1003108721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17950 PRESTON RD STE 370",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752526205",
            "telephone_number": "972-630-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SUMMIT AVE",
            "address_2": "SUITE 430",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-710-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "HOSLEY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "972-630-4811",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.